NewYork-Presbyterian/Westchester Study Finds Transference-Focused Psychotherapy (TFP) Can Help Patients with the Condition
NEW YORK (July 24, 2007) — An intensive form of talk therapy, known as transference-focused psychotherapy (TFP), can help individuals affected with borderline personality disorder (BPD) by reducing symptoms and improving their social functioning, according to a new study led by physician-scientists at NewYork-Presbyterian Hospital/Westchester Division.
A chronic and disabling condition affecting more than three million Americans, BPD has long defied psychiatrists and psychologists seeking to treat the illness. Affecting day-to-day functions, symptoms of the illness include unstable relations with others, pervasive mood instability, chaotic variation in self-image, self-destructive behavior, impulsive behaviors (such as sexual promiscuity, substance abuse or gambling), and intense, uncontrolled rages.
Published in the American Journal of Psychiatry, the new study may be the first to compare dialectical behavior therapy (DBT), considered by many to be the standard, with two other psychodynamic treatments: supportive psychotherapy and TFP—a specialized psychodynamic form of talk therapy pioneered by NewYork-Presbyterian/Westchester's Dr. Otto F. Kernberg.
"This study shows the value of psychoanalytically-based treatment for borderline patients that focuses on the personality, rather than simply on symptoms, yet also shows improvements in symptoms," says Dr. Kernberg, the study's senior author and director of the Personality Disorders Institute at NewYork-Presbyterian/Westchester and professor of psychiatry at Weill Cornell Medical College. "In transference-focused psychotherapy, the patient is guided toward greater self-control and holistic outlook by recognizing and reconciling disparate ideas about themselves and others—a process that's revealed through the patient-therapist relationship."
The two other therapeutic methods take different approaches: DBT, a cognitively based therapy, is directed at developing skills to help the patient regulate emotions and reduce symptoms; and supportive psychotherapy provides emotional support such as advice on the daily problems facing the patient.
"Our study showed that structured treatment for borderline patients is effective, and patients improved with treatment. While the three approaches were not equally beneficial in all areas, overall, TFP brought about the greatest range of positive change, alleviating more symptoms and helping patients better function in their daily lives," says Dr. John F. Clarkin, lead author of the study, co-director of the Personality Disorders Institute at NewYork-Presbyterian/Westchester and professor of clinical psychology at Weill Cornell Medical College.
Patients in the TFP treatment showed improvement in ten out of the twelve areas studied, including suicidality, anger, one kind of impulsivity, irritability, verbal assault and direct assault. All three treatments helped alleviate the impact of BPD. By comparison, supportive psychotherapy showed improvment in six areas, and DBT in five.
Study co-authors include NewYork-Presbyterian/Westchester's Dr. Kenneth N. Levy and Dr. Mark F. Lenzenweger of Binghamton University, State University of New York.
The study was supported, in part, by the Borderline Personality Disorder Research Foundation, the Depression-Borderline Personality Program, the Dworman Family Foundation, the Pasarow Foundation, the Pritzker Network, the Dewitt Wallace Foundation, and the Personality Disorders Institute in the Department of Psychiatry at Weill Cornell Medical College.
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NewYork-Presbyterian Hospital/Westchester Division
NewYork-Presbyterian Hospital/Westchester Division, opened in 1894, is one of the world's most advanced centers for psychiatric care. The Westchester Division serves children, adolescents, adults and the elderly with comprehensive outpatient, day treatment, partial hospitalization and inpatient services. In addition to clinical treatment, the Westchester Division is also a center for interdisciplinary medical research and education through its academic affiliate, Weill Cornell Medical College. NewYork-Presbyterian is one of the nation's top hospitals for psychiatry, as rated by U.S.News & World Report. For more information, visit www.nyp.org.
Eliza S. Whoriskey
esw9002@nyp.org